MP78-05 ETIOLOGY-SPECIFIC PATTERNS OF INFLAMMATION IN ANTERIOR URETHRAL STRICTURE DISEASE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP78-05 ETIOLOGY-SPECIFIC PATTERNS OF INFLAMMATION IN ANTERIOR URETHRAL STRICTURE DISEASE Wade Gutierrez, Benjamin Breyer, Sean Elliott, Jeremy Myers, Alex Vanni, Katherine Christel, Laila Dahmoush, and Bradley Erickson Wade GutierrezWade Gutierrez More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , Sean ElliottSean Elliott More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Alex VanniAlex Vanni More articles by this author , Katherine ChristelKatherine Christel More articles by this author , Laila DahmoushLaila Dahmoush More articles by this author , and Bradley EricksonBradley Erickson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003355.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nearly 50% of anterior urethral strictures are of idiopathic etiology. To investigate the underlying biology of idiopathic strictures, we compared inflammatory profiles of idiopathic strictures with those of known etiology, specifically trauma/iatrogenic strictures and lichen sclerosus strictures. We hypothesized that each group would contain distinct inflammatory features. METHODS: Five centers prospectively enrolled patients into an NIDDK-funded study evaluating inflammation in anterior urethral stricture disease. Subjects underwent standard urethroplasty per surgeon routine and tissue was sent to a centralized repository. H&E-stained sections of stricture tissue and stricture-adjacent urethral tissue (1 cm from stricture when available) were examined by a single, blinded pathologist and evaluated for degree of inflammation and primary inflammatory cell type. RESULTS: 133 strictures were analyzed: trauma/iatrogenic (n=32), idiopathic (n=74), and lichen sclerosus (n=27). Inflammatory cells were present in 40.6% of trauma/iatrogenic samples, 63.5% of idiopathic samples, and 59.3% of lichen sclerosus samples [A]. Stricture-adjacent urethral tissue was collected from 44 subjects with inflammation in their strictures. Stricture-adjacent tissue from 38 of these subjects (81.8%) contained inflammation [B]. Degree of inflammation was higher in idiopathic strictures than in trauma/iatrogenic strictures (1.42 vs 0.81, 5-point Likert scale, p=0.049) [C]. Idiopathic and lichen sclerosus strictures were similar in degree of inflammation (1.42 and 1.41, respectively, p>0.999) and the distribution of inflammation severities among samples. The predominant inflammatory cell types in idiopathic strictures resembled trauma/iatrogenic strictures [D]. CONCLUSIONS: Anterior urethral strictures display etiology-specific patterns of inflammation severity and composition. Though remote trauma is often postulated as the cause of idiopathic strictures, pathologically they resemble the pattern of chronic inflammation seen in lichen sclerosus strictures, suggesting potential overlap in underlying pathophysiology. Source of Funding: NIDDK 1R21DK115945-01 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1133 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wade Gutierrez More articles by this author Benjamin Breyer More articles by this author Sean Elliott More articles by this author Jeremy Myers More articles by this author Alex Vanni More articles by this author Katherine Christel More articles by this author Laila Dahmoush More articles by this author Bradley Erickson More articles by this author Expand All Advertisement PDF downloadLoading ...